Public Forum for SUD 1115 Medicaid Waiver – 03/27/2020 Details Date: March 27th, 2020Time: 1:00 pm - 3:00 pmLocation: 50 W. Town Street, #400, Columbus, OH 43215Room: C621*Please register no more than 1 representative from the same organization. *Registration deadline is 12 pm, Thursday, March 26th, 2020 OK Question Title * 1. Name of Organization: OK Question Title * 2. Number of Registrants from your Organization: (please, no more than 2) 1 2 OK Question Title * 3. Name of first registrant: OK Question Title * 4. Email address of first registrant: OK Question Title * 5. Name of second registrant (if applicable): OK Question Title * 6. Email address of second registrant (if applicable): OK Question Title * 7. Telephone number: OK Question Title * 8. Do you require any special accommodations? Yes No If yes, please explain what accommodations are needed. OK Question Title * 9. Any other comments? OK NEXT